Sunday, September 23, 2007

A stunningly written piece by the Gary Post-Tribune's Jerry Davich shares the story of a six-tours-in-Iraq medic that hits many of the notes that we've heard so much about with combat PTSD. But the song played this time is especially moving since our protagonist received his psychological wounds while saving the lives of many of our most physically wounded soldiers.

Fortunately, this military family says their local VA is doing tremendous work with them, which is absolutely wonderful to hear.

Kim Cox choked up before her husband could reply. She knew his feelings all too well.

"Even knowing the outcome and problems I have now," Cox said, staring past Kim, "I'd do it all over again, no doubt about it."

David reached for a sip to drink. Kim reached for a Kleenex.

Since the war in Iraq began, David has served six tours of duty as a critical care nurse for the Indiana Air National Guard. He helped transport roughly 500 critical patients during 156 combat missions, body after body, death after death.

It all caught up to him earlier this year.

Click on 'Article Link' below tags for more...

In the interest of education, articles quoted from extensively.

Continuing:

Cox, a staunch supporter of the war from day one, lost 57 pounds in one month while in Iraq. That's when he stopped sending photos of himself back home to Kim. That's when he couldn't shake the nightmares and the sadness. That's when Kim knew something was wrong with her husband of 30 years but couldn't do anything from 7,500 miles away. ...

After finally arriving home in June -- he's been home only nine months in the past four years -- he went away once again, but this time for residential treatment in an out-of-state military medical facility. There he talked with other soldiers with PTSD. It helped. It healed. But it's only a start.

It pounds away at the 56-year-old Indiana Air National Guard critical care nurse with repeated rounds of depression, anxiety, panic, jumpiness, agitation, you name it.

He received psychological care while in Iraq, but the constant mortar shelling and combat missions didn't help his treatment. Plus, this past 10-month tour, the last of six since the war began, was his busiest and deadliest. Back and forth from Balad to Germany, patient after patient, body after body.

In May, while aboard a flight for the United States from Qatar, his emotions ambushed him again and he had to be hospitalized there, delaying his homecoming. He finally returned here late last month.

The reporter shares his experience of the heroic, human medic:

I first wrote about Cox in 2003, just after the Iraq War began.

I first met him in 2005, soon after he returned home from his second tour of duty.

In his basement, standing in front of two American flags draping the walls, each with handwritten notations of the combat missions he has performed, I remember asking Cox how he's able to emotionally absorb all the wounded, dying, and sometimes dead U.S. soldiers he transports.

How, I asked him in 2005, does he deal with this, one bloody or burned body after another, over and over, mission after mission? In his calm voice and low-key demeanor, the graying father of three told me simply, "It's what I do."

Since then, Cox has always represented to me what's good about a bad war, what's right about a wrong decision, and what's best about a worst situation. Oh, and along the way he helped rescue an Air Guard record 450 soldiers during 156 combat missions.

So when Kim e-mailed me saying David was coming home last month, I didn't think anything of it. I figured the Air National Guard's true iron man, the son of a U.S. Air Force retiree, would return to the region unscathed, again, after dodging so many proverbial bullets.

Well, I was wrong.

He got hit -- in his psyche -- by all the combat tours, the human carnage, and the unspeakable images he witnessed.

"I guess it finally caught up to me," Cox told me.

Cox and his family are now busy getting their lives back together, seeking the the peace and contentment that they deserve after the many great sacrifices they've made in peace-of mind.

David spends his time getting accustomed to civilian life again. The simple pleasures of grocery shopping with Kim, drives in the car with their dog Murphy, or doing absolutely nothing but watching life's wheels go 'round and 'round.

But the couple never knows what will trigger David's PTSD -- sometimes a photo of the war, sometimes a news account, sometimes a harmless TV show showing a doctor giving a patient a shot. And sometimes the trigger comes from within -- a memory, a flashback, an unexplained sense of dread.

Kim uses the word "sickness" to describe her husband's condition. "It's a mental illness, a disability," she explained. But David doesn't use that term. He calls it a sadness. "Knowing I'm not going back helps a lot," he said. "I don't want to see sand or 130-degree heat for a long time. I don't miss it at all."

The Cox family uses jokes and humor to bind them together but also to deflect the hard times these past few months. They laugh more than cry, they smile more than they frown.

"So many others came back in a lot worse shape than me," David said matter-of-factly, "with one less arm or leg or eye. I have no right to complain."

Last year, Kimberly Cox wrote the Chicago Sun-Times about her husband during the paper's 'Yellow Ribbon Week' remembrance of the third year of the Iraq War:

My husband, Maj. David Cox, is currently serving his fourth deployment in support of Operation Iraqi Freedom. He is 56 years old. We have been married 28 years. David's military career began at the tail end of Vietnam. He jokes that it is the only lottery he ever won.

After finishing college, he left the military for a civilian nursing career. The military never left his thoughts, and in 1998, he decided to come back in, joining the Air National Guard. He received his commission and is based with the 122nd out of Fort Wayne.

They knew on 9/11 that their lives would be changed forever:

David's alert started that day.

When he was deployed the first time, we didn't know what to expect. I don't really want to say that we are used to it by now, but we do know what to expect. We know that sacrifices have to be made, and we both feel our sacrifices are small compared to what others have had to give.

In the past four years we have had only one holiday season together. This past year was the first time we were together in three years for our anniversary. When our daughter got married, we didn't know until two weeks before her wedding if her dad would be there to walk her down the aisle. He left two days after her wedding. He was not here when our first grandchild was born.

That being said, we feel blessed to be a part of helping the spread of democracy in the world. We both truly believe in our country's missions in Iraq and Afghanistan.

It is difficult to be apart so much. I think the hardest thing is just not being able to talk to each other whenever you feel like it. I miss my husband, but I try very hard to act with dignity and support him. He can't do his job correctly if he has to worry about me falling apart. That could endanger his life and the lives of those entrusted to his care.

Kathie Costos over at Wounded Times wrote a thoughtful intro to the Post-Tribune piece when she shared it with her readers tonight:

I keep trying to tell veterans that PTSD does not care if they support the mission they were given or not, support Bush or not, because in the end, that really doesn't matter. What matters is they were a human willing to serve. PTSD only cares that it can feed off of trauma and it doesn't get more traumatic, more horrific than combat. It doesn't know if the person held a gun, had the gun pointed at them or cleaned up after the shooting and blowing up stopped. ...

David Cox served six tours as a nurse in Iraq. Even now as you will read, he would go back if he could. So please stop letting people get away with attacking combat veterans with PTSD as being cowards, being lazy, being "un-patriotic" or all just being against Bush. Don't pass them off as if no one pays attention to them because people do. It has nothing to do with character, being brave or anything else because it comes to people from all sides. It is nothing to be ashamed of because they are wounded humans who survived an abnormal situation. Can you get more abnormal than combat?

They do not all end up with the same level of PTSD and they do not all end up snapping or committing suicide. Sadly they do not all heal either. Some never seek the help they need. They just need someone to reach out to them as one human to another human. No politics and no judgments. Just help.

Sending my very best wishes to the entire Cox family. And a big thank you to the great reporting of the Post-Tribune.

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While a wide variety of events can trigger what's called post-traumatic stress disorder, this PTSD blog focuses solely on the combat-related variety.
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Considerable Quotes

"The first shamans earned their keep in primitave societies by providing explanations and rituals that enabled man to deal with his environment and his personal anguish. Early man, no less than we, dealt with forces that he could not understand or control, and he attempted to come to grips with his vulnerablity by trying to bring order to his universe." -- Richard Gabriel in No More Heroes

"War stories end when the battle is over or when the soldier comes home. In real life, there are no moments amid smoldering hilltops for tranquil introspection. When the war is over, you pick up your gear, walk down the hill and back into the world." -- OIF vet John Crawford in The Last True Story I'll Ever Tell

"After wars' end, soldiers once again become civilians and return to their families to try to pick up where they left off. It is this process of readjustment that has more often than not been ignored by society. -- Major Robert H. Stretch, Ph.D in Textbook of Military Medicine: Vol. 6 Combat Stress

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